Heads and Hearts
The Human Side of Global Risks
The Global Risks Report tends to deal with structural issues: systems under stress, institutions that no longer match the challenges facing the world, adverse impacts of policies and practices. All these issues entail widespread human costs in terms of psychological and emotional strain.
This is usually left implicit but it deserves more attention—and not only because declining psychological and emotional well-being is a risk in itself. It also affects the wider global risks landscape, notably via impacts on social cohesion and politics.
This chapter focuses explicitly on this human side of global risks. For many people, as explored in the first two sections, this is an increasingly anxious, unhappy and lonely world. Anger is increasing and empathy appears to be in decline. The chapter examines the ramifications of complex transformations in three areas— societal, technological and work-related. A common theme is that psychological stress is related to a feeling of lack of control in the face of uncertainty.1
The age of anger
Every year Gallup takes a large-scale snapshot of the world’s emotional state. It asks respondents—154,000 across more than 145 countries in 2017— whether they had various positive and negative experiences on the preceding day. Overall, the positive experiences (such as smiling, respect and learning) comfortably outstrip the negative (which include pain, worry and sadness)—but the trend lines are worrying.
As illustrated by the graphs in Figure 3.1, the positive experience index (a composite measure of five positive experiences) has been relatively steady since the survey began in 2006. Meanwhile, the negative experience index has broken upwards over the past five years. In 2017, almost four in ten people said they had experienced a lot of worry or stress the day before; three in ten experienced a lot of physical pain; and two in ten experienced a lot of anger.2
Figure 3.1: Emotional Downturn
Source: Gallup 2018 Global Emotions Report. https://www.gallup.com/analytics/241961/gallup-global-emotions-report-2018.aspx
Note: Scores on the two indices range from 1 to 100. Higher scores on the Positive Experience Index indicate more positive experiences; on the Negative Experience Index they indicate more negative experiences.
Although still the least prevalent of Gallup’s negative experiences, anger is commonly referenced as the defining emotion of the zeitgeist. Some suggest this is an “age of anger”, noting a “tremendous increase in mutual hatred.”3 And while it is conceivable that public anger can be a unifying and catalysing force—a hope often expressed at the start of the decade in relation to the Arab Spring4—it has since come to be seen more as politically divisive and societally corrosive.
In the United States, public opinion researchers note that where opposing political groups previously expressed frustration with each other, they now express fear and anger.5 In one survey, almost a third of respondents reported having stopped talking to a family member or friend over the 2016 presidential election.6 In another, 68% of Americans said they were angry at least once a day; women reported themselves more angry than men, as did the middle class relative to their richer and poorer peers.7 Anger has long been associated with loss of status.8 Recent research also suggests a strong link with group identity.9 The risk is that this combination generates angry polarization—an increasingly prevalent feature of politics in many countries. And as further explored in the technology section below, in recent years group identities have been hardened by a process of “social sorting” that has eroded traditional, cross-cutting societal ties.10
Global trends in mental health
Gallup’s finding that negative experiences are on the rise chimes with World Health Organization data suggesting that depression and anxiety disorders increased by 54% and 42%, respectively, between 1990 and 2013.11 They rank second and seventh, respectively, in the global burden of disease; five of the top 20 are mental illnesses.12 Worldwide, 700 million people are estimated to have a mental disorder.13
Not all data confirm the finding that the prevalence of mental health problems is rising, but there are indications that the current generation of young people in particular are experiencing significant increases. In the United States, for example, the proportion of the total population with depression increased from 6.6% in 2005 to 7.3% in 2015, but the rise was much sharper for individuals aged between 12 and 17, where prevalence increased from 5.7% to 12.7%.14 One study found that between five and eight times as many US students in 2007 reported psychopathological symptoms on a standardized survey than their counterparts in 1938. These trends are particularly pronounced for American girls—in 2016 one in five had experienced a major depressive episode in the previous year.15 Concerns have been raised about a loosening of diagnostic criteria, but behavioural evidence points in the same direction. The rate of self-harm for girls aged between 10 and 14 nearly tripled between 2009 and 2015 and the suicide rate for 15- to 19-year-olds increased by 59% over the same period.16
Where opposing political groups previously expressed frustration with each other, they now express
fear and anger
Recorded rates of mental health disorders are higher in the West—the lifetime prevalence rate for anxiety ranges from 4.8% in China to 31% in the United States. Suggested explanations for this have included reporting bias, methodological factors and the possibility that in poorer circumstances mental suffering is more likely to be seen as an expected part of life than a diagnosable condition.17 Nonetheless, people with mental health conditions in lower-income countries can face profound difficulties: one study across 28 countries found treatment gaps of up to 85%.18
Within affluent countries, wealth affects well-being in complex ways. The prevalence of anxiety disorders is higher among lower-income groups. But attitudes towards money matter too—researchers have linked reduced well-being to societal shifts away from intrinsic motivations (related to community feeling and affiliation) and towards extrinsic motivations (related to financial success and social status).19 This is generationally significant: in one US study, 81% of 18- to 25-year-olds said that getting rich was their generation’s top or second goal, compared to 62% of 26- to 39-year-olds.20 Another important generational pattern relates to expectations of increasing quality of life. As illustrated by Figure 3.2, there is significant variation across countries in terms of young people’s perceptions of how their lives will compare to those of their parents. Only 5% of survey respondents in China expect to live a worse life than their parents, compared with 30% in the United States and the United Kingdom and almost 60% in France.21
Figure 3.2: Life Prospects
“Will you have had a better or worse life than your parents’ generation?” (% of respondents)
Source: Ipsos Global Trends, 2016. https://www.ipsosglobaltrends.com/life-better-or-worse-than_parents/
Violence, poverty and loneliness
What is contributing to these patterns of increased negative experience? Societal stressors are the first potential driver considered. Violent conflict remains one of the most potent causes of emotional and psychological distress. There is a danger of complacency here, because conflict-related deaths have fallen sharply since the middle of the 20th century, as shown in Figure 3.3. However, as the figure illustrates, the overall number of conflicts is close to the highs of the early 1990s and has risen in recent years.22 While not mass death conflicts, these are clearly a source of emotional and psychological distress for huge numbers of people, particularly in Africa, the Middle East and South Asia.23
Figure 3.3: Conflict and Death
The same is true for violence of other sorts. The prevalence of homicide is particularly important, because it influences overall perceptions of security.24 Although the global rate fell for a decade before a marginal uptick in 2016,25 regions are affected very differently: Latin America accounts for 8% of the world’s population but 33% of its murders.26 Similar trendlines are not available for “intimate partner violence”, but the World Health Organization estimates that around 30% of women globally experience it during their lives, and that it doubles the risk of depression.27 In 2017, 137 women were killed every day by intimate partners or family members.28
The proportion of the world’s population living in poverty has dropped significantly in recent decades, alleviating one of the key threats to physical and mental well-being,29 but increases in the global population mean the absolute numbers are still extremely high. In 2015 there were 736 million people living on less than US$1.90 a day, and numbers were increasing in Sub-Saharan Africa, the Middle East and North Africa.30 And even in high-income countries, income and wealth disparities—ranked fourth as a driver of the global risks landscape in our survey this year—have been linked to increasing mental health problems.31
A third societal stressor is loneliness. This is on the rise, in the West in particular, where household structures have been undergoing a profound shift. Researchers call the current share of people living alone “wholly unprecedented historically”.32 In the United Kingdom, the average proportion of single-person households has increased from around 5% in pre-industrial communities to 17% by the 1960s and 31% in 2011. Similar figures are recorded in Germany, Japan, the Netherlands and the United States.
Many capital cities have even higher proportions of so-called “solitaries”—for example, 50% in Paris and 60% in Stockholm. In midtown Manhattan 94% of households are single-person. Researchers argue that urbanization can weaken family and other bonds relative to smaller, rural communities;33 this may help to explain high-income countries’ apparently higher prevalence of mental health problems.34 Evidence of psychological strains related to urbanization also comes from emerging economies: in China, where the rural population plunged from 80.6% to 45.2% between 1980 and 2014,35 research finds increased levels of loneliness both among migrants moving to cities and in the rural communities they have left.36
The latest official data in the United Kingdom point to an increase to 22% in 2017 in the proportion of people feeling lonely either sometimes, often or always, up from an average of 17% in 2014–16.37 The proportion of people never feeling lonely decreased from 33% to 23% over the same period. A US study looked at how many close friends people have: the average fell from 2.9 in 1985 to 2.1 in 2004, and the proportion of people responding that they had no close friends tripled over that period to become the modal response.38
Research suggests that people who describe themselves as lonely have as much social capital as their non-lonely peers.39 One of the behavioural patterns linked to loneliness is poorer sleep quality, which has knock-on effects on individuals’ wider resilience.40 There are early signs that the potential societal impacts of rising loneliness are beginning to be recognized as a problem requiring attention—in early 2018, the United Kingdom added loneliness to the remit of one of its government ministers.
Technology, addiction and empathy
In one recent study, technology was cited as a major cause of loneliness and social isolation by 58% of survey respondents in the United States and 50% in the United Kingdom.41 However, the same survey found that social media was viewed as making it easier for people to “connect with others in a meaningful way”, and respondents who reported feeling lonely were no more likely than others to use social media. These findings exemplify the uncertainty around how technological changes impact individual well-being. Technological change is always a source of stress, but the current wave of change—the Fourth Industrial Revolution— is defined by the blurring of the line between the human and the technological.
Debate, for example, surrounds the claimed addictiveness of digital technologies.42 UK research in mid-2018 found that people spend an average of 24 hours per week online—more than twice as much as in 2011.43 At least one prominent endocrinologist has likened digital technologies to addictive substances—in that they stimulate dopamine, which produces pleasure, but also require increasing use to get the same effect.44 Many business models rely on the efficiency with which new technologies can attract and retain users’ attention; some companies have even marketed their ability to leverage the behavioural impact of dopamine.45 However, others argue that claims of addictiveness are alarmist or overblown:46 the UK research found people still spend less time online than they do watching television.
Researchers looking at early child development are worried less by addiction than risks of “functional impairment”—that digital technologies could crowd out interpersonal interactions that provide the building blocks for subsequent development, such as the ability to “concentrate, prioritize, and learn to control passing impulses”.47 The American Academy of Pediatrics now recommends that children up to 18 months old use screens only for video chats, and a limit for children up to 5 years old of one hour of “high quality” programming, watched with a parent.48
Among adolescents, a study of more than 500,000 US school students found those who spent more time on digital media— relative to non-digital activities such as sports, in-person interactions, homework, printed media or religious services—were more likely to report mental health issues.49 Critics contest these findings, particularly for moderate levels of screen time. They also note that even with high levels of screen time the effects remain small compared to, for example, missing breakfast or not getting enough sleep.50
Another potential concern is that technology is leading to a decline in empathy, the ability to put oneself in the shoes of another. One study of students in the United States found that levels of empathy had fallen by 48% between 1979 and 2009;51 however, possible explanations for this other than the greater use of personal technologies include increasing materialism and changes in parenting practices. Debate often centres on how digital echo- chambers can weaken cross- society empathy by anchoring individuals in tight-knit sub-groups.
Other technologies also play a role—such as online dating platforms leading to sorting and matching processes that researchers find are reducing cross-cutting societal bonds.52
The relationship between technology and empathy seems to be nuanced: online connections can be empathetic, but research suggests the effect is six times weaker than for real-world interactions.53 Some believe virtual reality (VR) technologies will become an “engine for empathy”.54 Others note, for example, that current online gaming is negatively correlated with empathy,55 which might suggest that more immersive VR versions of similar games would strengthen the negative effect. Some suggest that emotionally responsive robots could tackle loneliness, particularly in care- related settings. But this is not without potential risks—we consider potential dangers in Future Shocks, on page 73.56
Automation, monitoring and workplace stress
Technological and societal change is linked to rapid transformations in the workplace—and what happens at work has the potential to affect emotional and psychological well-being.57 According to a survey of full-time employees in 155 countries, just 15% feel “highly involved in and enthusiastic about their work”.58 This “engagement” rate varies from 33% in the United States to just 6% across East Asia, a result the researchers attribute to overwork. Globally, a higher proportion of employees—18%—were found to be actively disengaged, defined as “resentful and acting out their unhappiness”.59
For many workers, a pronounced recent change has been a blurring of the line dividing work from the rest of life.60 Work-related emails often begin long before the start of nominal working hours and finish long afterwards. Many families juggle multiple jobs with childcare, stressful commuting logistics and caring for elderly parents. In growing numbers, employees cite the ability to manage work/life balance as the most important thing for thriving at work.61 According to one study, 50% of American workers say they are “often or always exhausted due to work”, up by almost a third in 20 years.62 In another study, when UK workers were asked to identify the main workplace causes of stress, half cited unrealistic time pressure and demands. The same study noted employees’ concern about lack of consultation on workplace changes (31%) and lack of control over the work they do (27%).63
Automation has long been a source of disruption in the workplace. It has allowed huge numbers of employees to move up the value chain and escape monotonous and dangerous tasks, but as far back as 1959 the World Health Organization was noting adverse psychological impacts not just of automation but even of the prospect of automation.64 Research published in 2018 suggests that, in the United States, a 10% increase in the likelihood of being affected by automation is associated with decreases in physical and mental health of 0.8% and 0.6%, respectively.65
Technology is also making it easier for employers to monitor workers; some suggest the level of “anticipatory conformity” this can encourage amounts to a surrogate form of automation.66
No amount of law or regulation will overcome a
lack of empathy
One of the sectors in which concerns about automation and monitoring have become most prominent is online retailing, where the level of efficiency with which warehouses in particular can now operate has led to numerous reports of productivity targets causing physical and psychological strain among workers. However, workplace monitoring can actually reduce output if workers perceive it as an indication of distrust.67 Loss of privacy due to monitoring may have a similar effect: a study in a Chinese factory found that workers shielded from monitoring by a curtain were 10–15% more productive than their peers.68 Conversely, in a study of US restaurants where monitoring was being used to deter employee theft, large increases in weekly revenues were recorded—the result of unexpected improvements in levels customer service.69
Wider changes in the structure of work and in its place in society are a further source of potential stress. Job security and stability are in decline in many advanced economies, with real earnings growth sluggish or stagnating and less predictable “gig economy” work expanding. In many low- income countries, meanwhile, secure and stable employment has always been the exception: for example, 70% of employment in Sub-Saharan Africa is classified as “vulnerable” by the International Labour Organization.70
Evidence from the workplace reinforces concerns about growing problems with mental health. In the United Kingdom, an independent review found that while sickness- related absences overall fell by more than 15% between 2009 and 2017, absences related to mental health problems increased by 5%.71 Of course, not all mental health problems recorded in the workplace are caused in the workplace—but employers and regulators ought to ensure that workplace conditions are not triggering or exacerbating problems. The UK review recommended revising health and safety provisions to take greater account of mental as well as physical well-being.
In the 19th century, physical health and safety rules and practices reshaped work in many industrializing economies. In the 21st century, mental health and safety rules and practices could play an analogous role by ensuring that workplace conditions are appropriate for an increasingly knowledge-based economy.
Why well-being matters
This chapter has focused on some of the drivers leading to increased individual harm and distress. The chapter considered societal, technological and workplace trends, but could equally have examined how other transformations are linked to declining well-being, from political uncertainty to demographic change and environmental disruption.
Individual harms matter in themselves, but they can also feed into wider systemic risks and challenges. For example, there are huge economic costs. Research by the World Economic Forum and the Harvard School of Public Health suggests that the global economic impact of mental disorders in 2010 was US$2.5 trillion, with indirect costs (lost productivity, early retirement and so on) outstripping direct costs (diagnosis and treatment) by a ratio of around 2:1.72
Beyond the economic risks, there are potential political and societal implications. For example, a world of increasingly angry people would be likely to generate volatile electoral results and to increase the risk of social unrest. If empathy were to continue to decline the risks might be even starker, in some societies at any rate: “empathy underwrites all political systems that aspire to the liberal condition . . . and no amount of law or regulation will overcome a lack of empathy.”73
Internationally, repeated accusations have been made in recent years of rival states using technology to foment angry fragmentation and polarization. It is not difficult to imagine such emotional and psychological disruptions having serious diplomatic—and perhaps even military—consequences.